CN114222602A

CN114222602A - Improved device of conduit

Info

Publication number: CN114222602A
Application number: CN202080056551.3A
Authority: CN
Inventors: F·D·麦克沃伊; C·康诺利
Original assignee: Medtronic Vascular Inc
Current assignee: Medtronic Vascular Inc
Priority date: 2019-08-13
Filing date: 2020-08-10
Publication date: 2022-03-22
Also published as: WO2021030239A1; US20210046289A1; US11813417B2; EP4013598A1

Abstract

The conduit flaring device (560) includes a housing and a pin (550). The housing includes an inner surface (564) defining a cavity (566) configured to receive at least a portion of a conduit having an entry port (508) and engage an outer surface (503) of the conduit (502) proximate the entry port. The pin is configured to advance into the entry port of the catheter to increase a cross-sectional dimension of the entry port. Flaring the access port may help reduce medical device jamming on the access port of the catheter during a medical procedure.

Description

Improved device of conduit

Technical Field

The present disclosure relates to medical devices.

Background

Medical catheters may be used with a variety of medical procedures. For example, in certain instances, medical catheters may be used to deliver medical devices and/or compositions within the vasculature of a patient.

Disclosure of Invention

The example devices, systems, and techniques described herein may be used to increase the cross-sectional size (e.g., diameter in the case of a circular cross-section) of an access port into a catheter lumen. In some instances, the access port may be at the proximal end of the catheter, while in other instances, such as in the case of a guide extension catheter, the access port may be distal to the proximal end of the catheter. Increasing the outer cross-sectional dimension of the access port, referred to herein as the "flare" of the access port, can widen the access port without increasing the outer cross-sectional diameter of other portions (e.g., distal portions) of the catheter, which can facilitate introduction of a medical device into the catheter lumen without adversely affecting the navigation of the catheter through the vasculature of a patient. In some examples, the flaring device has a pin configured to be advanced into an access port of the conduit to increase a cross-sectional dimension of at least a portion of the access port. Flaring the access port may reduce the entrapment of medical devices on the access port, which may facilitate medical procedures using an inner catheter defining an outer diameter and an outer catheter defining an inner diameter that is greater than the outer diameter of the inner catheter.

In some examples, the present disclosure describes an apparatus including a housing and a pin. The housing includes an inner surface defining a cavity configured to receive at least a portion of a conduit having an entry port. An inner surface of the housing is configured to engage an outer surface of the conduit proximate the entry port. The pin is configured to be advanced into an entry port of the conduit when at least a portion of the conduit is positioned in the cavity so as to increase a cross-sectional dimension of the entry port.

In some examples, the present disclosure describes a medical device system including a catheter and a flaring device. The catheter includes an elongate body extending along a central longitudinal axis and defining a lumen terminating in an access port. The flaring device includes a housing and a pin. The housing includes an inner surface defining a cavity shaped to receive at least a portion of the conduit. An inner surface of the housing is configured to engage an outer surface of the conduit proximate the entry port. The pin is configured to be advanced into an entry port of the conduit to flare the entry port when at least a portion of the conduit is positioned in the cavity, thereby defining a flared lip extending away from the central longitudinal axis.

In some examples, the present disclosure describes a method that includes positioning at least one entry port of a conduit in a cavity of a housing of a flaring device. The catheter includes an elongate body extending along a central longitudinal axis and defining a lumen terminating in an access port. The flaring device includes a housing and a pin. The housing includes an inner surface defining a cavity shaped to receive at least a portion of a conduit including an entry port. An inner surface of the housing is configured to engage an outer surface of the conduit proximate the entry port. The method also includes, while at least one entry port of the conduit is positioned in the cavity of the housing, advancing a pin into the entry port of the conduit flaring the entry port to increase a cross-sectional dimension of the entry port.

The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the techniques described in the disclosure will be apparent from the description and drawings, and from the claims.

Drawings

Fig. 1 is a conceptual side view, shown in cross-section, of an exemplary medical device system including a catheter and an outer catheter.

Fig. 2A is a conceptual longitudinal cross-sectional view of an exemplary medical device system depicting an access port of a catheter positioned within a lumen of an outer catheter and into which a medical device is inserted.

Fig. 2B is a conceptual cross-sectional view of the exemplary medical device system depicted in fig. 2A, taken along line 2B-2B in fig. 3A.

Fig. 3A is a conceptual longitudinal cross-sectional view of an exemplary medical device system depicting a flared access port of an improved catheter positioned within a lumen of an outer catheter and a medical device inserted therein.

Fig. 3B is a conceptual cross-sectional view of the exemplary medical device system depicted in fig. 3B, taken along line 3B-3B in fig. 3A.

FIG. 4 is a conceptual side view of an exemplary medical device system including a flaring pin and a catheter.

Fig. 5 is a conceptual plan view of an exemplary medical device system including a catheter and a catheter flaring device including a housing and a flaring pin.

Fig. 6A and 6B are photographs depicting a top view and a side view of an exemplary conduit before flaring an access port, and fig. 6C and 6D are photographs depicting a front view and a side view of the conduit after flaring the access port.

FIG. 7 is a flow diagram depicting an exemplary technique for modifying an access port of a catheter.

Detailed Description

In some examples, the flaring device including the pin is configured to modify the access port of the lumen of the catheter, such as by increasing the cross-sectional size of the access port. As discussed in further detail below, increasing the cross-sectional size of the access port, referred to herein as the "flare" of the access port, may widen the access port without increasing the outer cross-sectional diameter of other portions (e.g., distal portions) of the catheter, which may facilitate introduction of a medical device into the catheter lumen without adversely affecting the navigation of the catheter through the vasculature of a patient.

The pin of the flaring device is configured to be advanced into an entry port of the conduit and increase a cross-sectional dimension of at least a portion of the entry port, such as by resizing and/or shaping a wall of the conduit defining the entry port. For example, advancing the pin a selected distance into the access port may cause at least a portion of the access port to flare in a radial direction. The flared portion of the entry point defines a flared lip of the catheter. The flared lip may include at least one of a selected orientation relative to the access port, a selected cross-sectional dimension (e.g., diameter or width), a selected length from the access port to an un-flared portion of the conduit, or may extend along an arc at a selected angle to the outer perimeter of the access port. In some instances, flaring the access port may facilitate introduction of a medical device into a catheter lumen without adversely affecting the navigation of the catheter through the vasculature of a patient. By flaring the entry port, the entry port into the catheter lumen may better correspond to the inner diameter of the second catheter, e.g., the catheter is positioned in the second catheter compared to an un-flared catheter. Although the second conduit is primarily referred to herein as an outer conduit or guide conduit, the second conduit may be any suitable type of conduit.

In some examples, the catheter may include a guide extension catheter including a pusher assembly and an elongate body having a distal end and a proximal access port. The guide extension catheter ("GEC") may include a rapid exchange percutaneous intervention (PCI) device. The elongated body of the GEC defines at least one lumen through which a medical device (e.g., catheter, guidewire, filter, stent delivery system, etc.), therapeutic agent, or other element can be introduced into the vasculature or other tissue site of a patient. The elongate body may be coupled to a pushing assembly that has a lower profile than the elongate body and facilitates pushability of the GEC through the outer catheter and/or through the vasculature of the patient. In some examples, the pusher assembly may include an elongate member and an anchor member positioned at a distal end of the elongate member.

Due to the flexibility and lower profile of the GEC, it may be more suitable than an outer catheter (e.g., a guide catheter) to guide through such severe tortuosity and/or calcification. In some instances, the clinician may push the GEC out of the distal end of the outer catheter as the outer catheter approaches such areas through which the outer catheter is difficult or impossible to extend. In some instances, when the GEC is pushed out of the distal end of the outer catheter, the GEC may be said to "stick out" of the outer catheter. In some instances, the GEC may provide additional back-up support for delivery of medical devices, therapeutic agents, or other elements introduced into the vasculature or other tissue site of a patient via an outer catheter.

In some cases, the clinician may select an outer catheter having a particular outer diameter (and corresponding inner diameter) and a GEC having an outer diameter that is less than the inner diameter of the outer catheter. The clinician may select a smaller diameter GEC to enable the GEC to be introduced into the inner lumen of the outer catheter. In addition, the clinician may select a smaller outer diameter GEC to enable the GEC to be guided to a target site that is relatively difficult to reach. A smaller outer diameter GEC may provide, for example, improved delivery capabilities and/or size advantages when navigating a patient's vasculature as compared to a larger outer diameter outer catheter or a larger outer diameter GEC. As an example, a clinician may use a guide catheter having an inner diameter of 7Fr and a GEC having an outer diameter of 5 Fr. As another example, a clinician may use a guide catheter having an outer diameter of 7Fr and a GEC of 7Fr, which may be specified as such because it is configured to be received in the inner lumen of a 7Fr guide catheter, but in fact has an outer diameter of less than 7Fr, e.g., less than 7Fr about 0.3 mm. This difference in the outer diameter of the GEC and the inner diameter of the outer catheter may be referred to as GEC mismatch.

During delivery of a selected medical device via the GEC and the outer catheter, a GEC mismatch may cause a portion of the medical device to become stuck at the entry port of the GEC. For example, a tip or other leading portion of a medical device positioned in the outer catheter lumen of the outer catheter and introduced into the GEC lumen may become lodged on the entry port of the GEC. Thus, additional force may be required to force the medical device into the GEC lumen via the access port and/or the clinician may need to spend additional time attempting to introduce the medical device into the GEC lumen via the access port, such as by withdrawing the medical device relative to the GEC access port and realigning the medical device with the GEC access port. The tip or other leading portion of the medical device may include, for example, the distal end of a catheter, a leading strut of a stent, a radio-fluorescent marker band, the leading edge of an inflatable balloon, or other feature of the medical device. To reduce the entrapment of medical devices on the access port of the GEC, the flaring devices, systems, and techniques described herein can be used to modify the access port of the GEC to better match the outer diameter of the GEC to the inner diameter of the guiding catheter. As such, the described flaring devices, systems, and techniques can reduce the above-described inconveniences associated with GEC mismatches.

Fig. 1 is a conceptual side view of an exemplary medical device system 100 including a catheter 102 and an outer catheter 104. Catheter 102 includes an elongate body 106 having an entry port 108, a pushing assembly 110, and a handle 112. In some examples, catheter 102 may include a GEC.

The catheter 102 defines a longitudinal axis X, which is shown in fig. 1 as the central longitudinal axis of the elongated body 106. In some examples, pushing assembly 110 may include an elongated member 109 and an anchor member 111. An anchoring member 111 may be positioned at a distal portion of the elongate member 109 and secured to a proximal portion of the elongate body 106 proximate the access port 108. For example, the anchoring member 111 may extend between layers of material forming the elongated body 106, may be adhered to a portion of the elongated body 106, or both. The elongate body 106 defines a proximal end 114 and a distal end 116. In some examples, a maximum cross-sectional dimension of elongate body 106 between proximal end 114 and distal end 116 may be less than a cross-sectional dimension of access port 108. The elongate body 106 is configured to provide a delivery member on the catheter 102 that can extend distally of the outer catheter 104 to protrude from a distal end of the outer catheter 104 and effectively extend the reach of the outer catheter 104 within the vasculature of the patient. Extending the reach of the outer catheter 104 may enable devices, reagents, and/or any other suitable components to be delivered to a target site that may be difficult to reach with the outer catheter 104.

In some embodiments, the elongate body 106 includes a tapered portion 118, a proximal portion 120, and a distal portion 122. The tapered portion 118, the proximal portion 120, and the distal portion 122 may be integrally formed, or separate members adhered or otherwise connected together. The tapered portion 118 of the elongate body 106 tapers in a proximal direction toward the central longitudinal axis X. The tapering of the elongate body 106 at the tapered portion 118 may allow the elongate body 106 to be more easily retracted into the outer catheter 104. For example, during or after use of the catheter 102, a clinician may wish to retract at least a portion of the elongate body 106 into the outer catheter 104 by proximally retracting the push assembly 110 relative to the outer catheter 104. The tapered portion 118 may allow the elongate body 106 to enter the outer catheter 104 more smoothly.

The proximal portion 120 and the distal portion 122 may have similar or different hardnesses. For example, the distal portion 122 may have a hardness that is greater than the hardness of the proximal portion 120. In other examples, the distal portion 122 may have a hardness that is less than the proximal portion 120. The stiffer proximal portion 120 can help maintain the integrity of the proximal portion of the lumen 105 of the elongate body 106, which can help introduce a medical device from the access port 108 into the lumen 105 without adversely affecting the navigation of the catheter 102 through the patient vasculature. For example, the stiffer proximal portion 120 may help the access port 108 and the proximal-most portion of the elongate body 106 resist deformation to help maintain lumen integrity. In some examples, the proximal portion 120 can be about 1 centimeter (cm) to about 4cm long, such as about 2.5cm long or about 1.25cm long. In some examples, the distal portion 122 can be about 15cm to about 27cm long, such as about 24cm to about 26cm long, or about 25cm long. The length may be measured along the longitudinal axis X.

The outer catheter 104 defines an outer catheter lumen 124 through which the catheter 102 may be introduced to access a distal target site within, for example, a patient's vasculature. Thus, at least a portion of the outer conduit 104 may be configured to surround the conduit 102. In some examples, the outer catheter 104 may include a guide catheter. The outer catheter 104 may also define a distal opening 126, and in some examples, at least a portion of the catheter 102 may be configured to extend through the distal opening 126 and the distal side of the outer catheter 104. For example, at least a portion of the elongate body 106 of the catheter 102 may be configured to extend out of the distal opening 126 of the outer catheter 104 to extend through severe tortuosity or calcification within the body vessel. The catheter 102 may have a smaller radial profile and may be more flexible than the outer catheter 104 such that it may more easily traverse severe tortuosity or calcification within a body vessel than the outer catheter 104.

In some examples, to enable the catheter 102 to be introduced into the outer catheter lumen 124 and slide within the outer catheter lumen 124, the maximum cross-sectional dimension (e.g., outer circumference or outer radial profile) of the elongate body 106 of the catheter 102 may be smaller or differently shaped than the maximum cross-sectional dimension of the inner circumference (e.g., inner radial profile) of the outer catheter 104. In other words, the outer circumference of the conduit 102 may not match the inner circumference of the conduit 104. For example, where the

conduits

102, 104 have a circular cross-section, the inner diameter of the conduit 104 (defining the lumen 124) may be greater than the outer diameter of the elongate body 106. Lip 128 of entry port 108 of elongate body 106 is configured to reduce misalignment of the outer perimeter of conduit 102 with the inner perimeter of conduit 104. For example, as discussed below, the lip 128 may be a flared lip that flares radially outward relative to the central longitudinal axis X to reduce the space between the entry port 108 and the wall of the outer conduit 104 that defines the lumen 124.

The access port 108 may extend along the length of the elongate body 106 (the length being measured along the longitudinal axis X) from a proximal end 130 to a distal end 132. In some examples, the access port 108 may be angled from the distal end 132 to the proximal end 130 due to the tapered shape of the tapered portion 118 of the elongate body 106. The access port 108 may include a substantially straight or curved edge. In some examples, the access port 108 may be formed by scraping at least a portion 118 of the elongate body 106. In some examples, the access port 108 can have a length, as measured along the longitudinal axis X from the proximal end 130 to the distal end 132, of about 2 centimeters (cm) to about 10cm (e.g., 2cm to 10cm or nearly 2cm to 10cm, to the extent permitted by manufacturing tolerances), such as about 3.5cm to about 4.5cm or about 4 cm. It is believed that the tapered entry port 108 having a relatively long length and being angled from the distal end 132 to the proximal end 130 can facilitate smooth delivery of a medical device (e.g., an interventional medical device) into the lumen 105 of the elongate body 106 via the entry port 108 by guiding the medical device into the lumen 105.

The lip 128 is configured to increase the cross-sectional dimension of the outer perimeter of the access port 108. In general, the lip 128 may include any suitable shape or size to more closely match the outer circumference of the elongate body 106 with the inner circumference of the conduit 104 at the lip 128. In some examples, the lip 128 is asymmetric with respect to the central longitudinal axis X. In some examples, the angle of the lip 128 relative to the central longitudinal axis X is greater than 0 degrees to about 45 degrees (e.g., angle θ as depicted in fig. 3A). In some examples, the length of the lip 128 in a direction parallel to the longitudinal axis X is about 3 millimeters (mm) to about 5 mm. In some examples, the outer periphery of the lip 128 may subtend an angle from about 45 degrees to about 315 degrees. The shape and/or size of the lip 128 may be selected to define a relatively smooth transition between the elongate body 106 and the outer catheter 104, for example, when only a portion of the elongate body 106 extends distally from the distal opening 126 of the outer catheter 104 while another portion remains within the lumen 124 of the outer catheter 104 and/or when the proximal end of the elongate body 106 abuts the distal end of the outer catheter 104. Additionally, or alternatively, the lip 128 may provide a relative sliding fit within the outer conduit 104 when the elongate body 106 is at least partially within the outer conduit 104.

In some instances, a relatively smooth transition and/or sliding fit between the lip 128 and the inner surface of the outer conduit 104 may provide certain advantages. For example, medical devices and/or other elements may be more easily advanced from lumen 124 of outer catheter 104 to lumen 105 of elongate body 106 because the transition between lumen 124 and lumen 105 may be relatively smooth so that the delivered assembly does not get caught at access port 108 and/or at the transition from lumen 124 to lumen 105. As another example, the lip 128 can reduce leakage of fluid from the distal opening 126 of the outer catheter 104 when fluid is delivered through the outer catheter lumen 124 into the elongate body lumen 105. In some instances, flaring the access port 108 may facilitate introduction of a medical device into a catheter lumen without adversely affecting the navigation of the catheter 102 through the vasculature of a patient.

Although the access port 108 of the elongate body 106 is depicted as being positioned within the lumen 124 of the outer catheter 104 such that an interventional medical device or another medical device may be introduced from the lumen 124 of the outer catheter 104 into the lumen 105 of the elongate body 106 without exiting the lumen 124, in other examples, the catheter 102 may extend out of the distal opening 126 of the outer catheter 104 such that the proximal end 114 of the elongate body 106 is distal to the distal opening 126.

Fig. 2A is a conceptual longitudinal cross-sectional view of an exemplary medical device system 200 depicting an access port 208 of a catheter 202 positioned within a lumen 224 of an outer catheter 204 and into which a medical device 234 is inserted. Fig. 2B is a conceptual cross-sectional view of the exemplary medical device system 200 depicted in fig. 2A. The catheter 202 and the outer catheter 204 may be the same as or substantially similar to the catheter 102 and the outer catheter 104, respectively, as discussed above with reference to fig. 1, except for the differences described herein. For example, the catheter 202 includes a pusher assembly 210 coupled to the elongate body 206. Elongate body 206 extends along a longitudinal axis and defines an access port 208 into lumen 205. Access port 208 extends along the length of elongate body 206 from a proximal end 230 to a distal end 232. In addition, the outer catheter 204 defines a lumen 224 through which the catheter 202 may pass.

As depicted in fig. 2A, the entry port 208 does not include a lip, and the conduit 202 and the outer conduit 204 define a mismatch 236. As discussed above, the mismatch 236 may include a difference between the outer diameter of the conduit 202 and the inner diameter of the outer conduit 204. Although discussed as a difference in diameter, in other examples, the difference may be with respect to another cross-sectional size or shape of the catheter 202 and the outer catheter 204. In some examples, the mismatch 236 may be from about 0.33mm to about 2mm, such as about 0.5mm to about 1 mm. Although the mismatch 236 is depicted as a gap extending within the lumen 224 between the upper surface of the elongate body 206 of the catheter 202 and the inner surface of the catheter 202, in some examples, the mismatch 236 may include a gap extending around any portion of the outer circumference of the elongate body 206.

In some instances, the mismatch 236 may cause at least a portion of the medical device 234 to become lodged on the entry port 208 as the medical device 234 is directed from the lumen 224 of the outer catheter 204 toward the catheter 202. The medical device 234 may include any suitable medical device, such as, but not limited to, a catheter, guidewire, filter, stent delivery system, therapeutic agent delivery device, or other element introduced into the vasculature or other tissue site of a patient. In some cases, the medical device 234 may include a lumen 238 (fig. 2B) such that the medical device 234 may be advanced over a guidewire 240. When the leading edge of the medical device 234 contacts the access port 208, the mismatch 236 may cause a portion of the medical device 234 to become stuck at the access port 208. For example, a leading edge strut of a stent of the medical device 234 may protrude in a radial direction so that the medical device 234 may snap over the access port 208. In some instances, the clinician may not be able to apply sufficient impulse to push the medical device 234 through the access port 208 when it becomes stuck at the access port 208, or the clinician must reposition one or more of the guidewire 240, medical device 234, or catheter 202 and again attempt to push the medical device through the access port 208. To reduce the medical device 234 from catching on the access port 208, a flaring device may be used to modify the access port 208, such as flaring the access port 208 to better match the outer diameter of the elongate body 206 to the inner diameter of the catheter 204.

Fig. 3A is a conceptual longitudinal cross-sectional view of an exemplary medical device system 300 depicting a flared access port 308 of a modified catheter 302 positioned within a lumen 324 of an outer catheter 304 and into which a medical device 334 is inserted. Fig. 3B is a conceptual cross-sectional view of the exemplary medical device system 300 depicted in fig. 3A, taken along line 3B-3B in fig. 3A. The catheter 302 and the outer catheter 304 may be the same as or substantially similar to the catheter 202 and the outer catheter 204, respectively, as discussed above with reference to fig. 2A and 2B, except for the differences described herein. For example, catheter 302 includes pushing assembly 310 and elongate body 306. The elongate body 306 extends along a longitudinal axis and defines a lumen 305 and an access port 308 into the lumen 305. The access port 308 extends along the length of the elongate body 306 from a proximal end 330 to a distal end 332. The outer catheter 304 defines a lumen 324 through which the catheter 302 may pass. The medical device 334 may be passed from the lumen 324 of the outer catheter 304 into the lumen 305 of the catheter 302 by advancing the medical device 334 over a guidewire 340 extending through a lumen 338 of the medical device 334.

As illustrated in fig. 3A, the access port 308 defines a lip 328. The lip 328 is configured to reduce a mismatch between the conduit 302 and the outer conduit 304 (e.g., mismatch 236 discussed above with reference to fig. 2A and 2B). In some examples, the angle θ of the lip 328 relative to the longitudinal axis X of the conduit 302 can be greater than 0 degrees to about 60 degrees, such as greater than about 0 degrees to about 45 degrees. The lip 328 may include (or define) at least one of a selected orientation relative to the access port 308, a selected cross-sectional dimension (e.g., diameter or length), a selected length L from the access port 308 to the un-flared portion 342 of the elongate body 306 of the conduit 302, or an arc subtending a selected angle to the outer perimeter of the access port 308. By flaring the entry port 308, the outer circumference of the conduit 302 may better correspond to the inner diameter of the second conduit 304 (referred to herein as the outer conduit) as compared to, for example, an un-flared conduit.

In some examples, the lip 328 may be asymmetric with respect to the longitudinal axis X. For example, the direction of the lip 328 may extend primarily in the y-direction (orthogonal x-y axes are shown in fig. 3A and other figures for ease of description only, and without giving any particular intended direction of use). In other words, lip 328 may extend in a radial direction away from nominally planar elongate body 106 (e.g., a plane of elongate body 106 that extends parallel to the x-axis prior to flaring access port 308), with flaring being more dominant in the y-direction. In other examples, the lip 328 may be oriented in any suitable direction. For example, only one longitudinal half of the access port 308 may extend radially away from the central longitudinal axis X to define a lip 328. In some examples, features of catheter 302, such as, for example, pushing assembly 310, may reduce or prevent flaring of access port 308 at circumferential portion 311 of elongate body 306 directly adjacent to pushing assembly 310. For example, the stiffness of the pushing assembly 310 relative to the elongate body 306 may prevent flaring of the elongate body 306 in a radial direction.

In some examples, an outer cross-sectional dimension (e.g., diameter) of the flared entry port 308 is substantially similar to an inner cross-sectional dimension (e.g., diameter) of the outer conduit 304. That is, the access port 308 including the lip 328 may define an outer surface of the conduit 302 that substantially matches (e.g., matches or nearly matches) an inner diameter of the outer conduit 304. As such, flared access port 308 may help reduce or even eliminate GEC mismatch and the resulting free space between elongate body 306 and the interior of outer catheter 304, which may cause medical devices to get caught at the leading edge of access port 308. Additionally, or alternatively, the flared access port 308 may facilitate introduction of a medical device into the lumen 305 of the catheter 302 without adversely affecting the navigation of the catheter 302 through the vasculature of the patient.

In some examples, the length L of the lip 328 in a direction parallel to the longitudinal axis X may be about 3 millimeters (mm) to about 5 mm. In some instances, the length L of the lip 328 may be selected to provide a selected flexibility of the lip 328. For example, a lip having a relatively shorter length L may be less flexible than a lip having a relatively longer length L. In some examples, the more flexible lip 328 may cause the lip 328 to have dimensions equal to or greater than the inner dimensions of the outer conduit 304. For example, when positioned within lumen 324, lip 328 may be curved to match the size or shape of the inner surface of outer catheter 304.

In some examples, the lip 328 extends along an arc 344 that subtends any suitable angle at the outer periphery of the access port 308. For example, as illustrated in FIG. 3B, the arcs subtend an angle of about 180 degrees. In other examples, the angle may be between about 45 degrees and about 360 degrees, such as about 45 degrees to about 315 degrees.

In some examples, the lip 328 may reduce the mismatch 336 to less than about 2mm, such as less than about 0.5mm, as compared to a mismatch without the lip 326 (e.g., the mismatch 236). By reducing the size of the mismatch 336, the medical device 334 can be guided from the lumen 324 of the outer catheter 304 into the lumen 305 of the catheter 302 with a lower likelihood of jamming or otherwise interfering with the trajectory of the medical device 334 over the entry port 308 as the medical device is advanced into the outer catheter lumen 305.

Fig. 4 and 5, discussed in detail below, depict an exemplary device, referred to herein as a flaring device, configured to flare an entry port of a conduit. In some embodiments, the described flaring device may comprise a plurality of flaring devices, each configured to be used with a selected conduit size and/or to produce a selected flare. For example, a first flaring device may be used with a 7Fr conduit to flare an access port to substantially correspond to 8Fr and a second flaring device may be used with a 5Fr conduit and configured to flare an access port to substantially correspond to 7 Fr. In this way, the clinician may select a flaring device that corresponds to the selected catheter size and the selected flare size.

Fig. 4 is a conceptual side view of an exemplary flared pin 450 ("pin 450") and catheter 402. The pin 450 is configured to be advanced into the entry port 408 of the conduit 402 to form the lip 428. For example, pushing the flared pin 450 into the access port 408 may increase the cross-sectional size of the access port 408. The catheter 402 may be the same as or substantially similar to the catheter 302 discussed above with reference to fig. 3A and 3B. For example, catheter 402 includes a pushing assembly 410 and an elongate body 406. Elongate body 406 extends along a longitudinal axis and defines a lumen 405 terminating in an access port 408. In some examples, the medical device system 400 may include an outer catheter (e.g., outer catheter 304) and/or a medical device (e.g., medical device 334).

The pin 450 may be formed of any suitable material having a suitable hardness to deform the entry port 408 of the conduit 402 to define the lip 428. In some examples, the pin 450 may comprise a metal, such as, but not limited to, stainless steel, titanium, or any combination thereof. In some examples, the pin 450 may comprise a relatively rigid plastic (e.g., more rigid than the elongate body 406 of the catheter 402), such as, but not limited to, an epoxy, a high density polyethylene, a polyvinyl chloride, a polycarbonate, an acrylic, or any combination thereof. In some examples, the pin 450 may include metal and plastic.

In some examples, the pin 450 is configured to flare a selected outer circumference (e.g., only a portion of the outer circumference) of the entry port 408 of the conduit 402. For example, the distal portion 452 of the pin 450 may define a conical shape. As one example, the distal end 454 of the pin 450 may have a cross-sectional dimension (e.g., diameter) that is less than a cross-sectional dimension of the un-flared configuration of the access port 408. As such, distal end 454 may be inserted into lumen 405 of elongate body 406, e.g., by a clinician via access port 408. The pin 450 may taper from a first cross-sectional dimension at a proximal portion 456 of the pin 450 to a second cross-sectional dimension that is less than the first cross-sectional dimension at the distal end 454. The taper may be substantially constant, vary in taper (e.g., increasing or decreasing taper), be stepped, or otherwise define a shape configured to deform at least a portion of the access port 408 to define a selected shape of the lip 428.

In some examples, the distal portion 452 of the pin 450 may define a conical shape having a central axis 453 that is eccentric relative to the central longitudinal axis X. As a result of the eccentricity, the pin 450 may cause the lip 428 to be asymmetrical with respect to the longitudinal axis X. For example, the lip 428 may extend radially away from the central longitudinal axis X more predominantly in the y-direction, or only one longitudinal half of the access port 408 may flare radially outward. As such, the pin 450 may be configured to flare the access port 408 in a selected direction, rather than radially outward in all directions about the central longitudinal axis X.

In some examples, the pin 450 may be configured to flare the entry port 408 by cold flaring, e.g., without applying heat to the conduit 102. In some examples, the pin 450 may include a heating element (not shown). An exemplary heating element may include, for example, a resistive metal coil that extends through a portion of the interior of the pin 450 and is coupled to a power source. When current is applied to the metal coil, the temperature of the metal coil may increase and thereby heat the pin 450 to a selected temperature. The temperature may be selected to soften and/or at least partially melt the material of the elongate body 406 of the conduit 402. In some examples, the heat may be applied by a heating element that is not located within the pin 450, for example, the heating element may be located in a housing (e.g., housing portion 562 described with reference to fig. 5) configured to surround at least a portion of the conduit 402. The pin 450 may more easily deform the access port 408 to define the lip 428 by softening and/or at least partially melting the material of the elongated body 406 of the catheter. In some examples, the elongated body 406 may better retain the selected shape of the lip 428 once cooled as compared to the pin 450 without the heating element. In this manner, the heating element may facilitate forming lip 428.

In some examples, the flaring pin 450 may be configured to be manipulated directly by a clinician. For example, the clinician may push the flared pin 450 into the access port 408. In some examples, the flaring pin 450 can be coupled to the housing such that the housing can engage at least a portion of the catheter 102, and the clinician can manipulate the flaring pin 450 or a member coupled to the flaring pin 450 to advance the flaring pin 450 into the access port 408.

Fig. 5 is a conceptual plan view of an exemplary medical device system 500 including a catheter 502 and a catheter flaring device 560 having a housing including first and

second housing portions

562A and 562B (collectively "housing portions 562") and a flaring pin 550 ("pin 550"). Although discussed with reference to fig. 5 as including two housing portions, in other examples, the conduit flaring device 560 can include a single, unitary housing. The conduit 502 and the pin 550 may be the same or substantially similar to the conduit 402 and the pin 450, respectively, discussed above with reference to fig. 4, except for the differences described herein. For example, conduit 502 includes a pushing assembly 510 and an elongate body 506 terminating in an access port 508. The pin 550 includes a distal portion 552 configured to flare a selected periphery of the entry port 508 of the catheter 502.

In some examples, the housing portion 562 is configured to engage the outer surface 503 of the conduit 502 proximate the access port 508. For example, the housing portion 562 may include respective

inner surfaces

564A and 564B (collectively "inner surfaces 564") that define

respective cavities

566A and 566B (collectively "cavities 566"). The cavity 566 may be configured to receive at least a portion of the catheter 502 including the access port 508. For example, the housing portions 562 may be coupled by hinges 568A and 568B such that the housing portions 562 are movable between an open configuration to receive the conduit 502 and a closed position in which the two housing portions 562 engage the conduit 502 as depicted in fig. 5. As such, the first and

second housing portions

562A, 562B are configured to move relative to one another to enclose at least a portion of the conduit 502.

In some examples, the shape of the inner surface 564 of the housing portion 562 may be configured to orient the entry port 508 of the conduit 502 in a selected direction relative to the pin 550. For example, the inner surface 564 may include one or more protrusions or recesses corresponding to features of the conduit 502, such as the access port 508 or the pushing assembly 510, such that the conduit 502 is received within the cavity 566 in a predetermined orientation. As such, the housing portion 562 may be configured to receive the catheter 502 in a predetermined orientation relative to the pin 550 and help prevent a clinician from inadvertently inserting the catheter 502 into the housing portion 562 in an unintended orientation.

In some examples, the cavity 566 may be shaped to correspond to a selected flared shape of the access port 508. For example, the cavity 566 may define a selected shape of the outer perimeter of the elongate body 506 after the access port 508 has been flared. As such, the housing portion 562 may be used to control the flaring of the access port 508, for example, to prevent the pin 550 from being pushed too far into the lumen 505, which may define a lip having a too long length (measured along the longitudinal axis of the catheter 502). As another, the housing portion 562 defining the pre-shaped cavity 566 corresponding to the desired amount of flaring of the access port 508 may help ensure that the access port 508 is sufficiently flared by providing tactile feedback to the clinician. The tactile feedback may be in the form of, for example, the clinician being unable to push the pin 550 further into the housing portion 562.

In some examples, pin 550 may be mechanically coupled to housing portion 562 and may be configured to travel in a predetermined direction, e.g., a linear direction. For example, the pin 550 may travel in one or more grooves, along one or more rails or similar structures that extend parallel to the x-axis and are defined by the inner surface 564B of the first housing portion 562A. As such, the second housing portion 562B may be mechanically coupled to the pin 550 in a sliding engagement. By mechanically coupling to the second housing portion 562B in a sliding engagement, the pin 550 may be moved between a first position in which the housing portion 562 is configured to receive the conduit 502 in the cavity 566B, as indicated by arrow 570, and a second position in which the pin 550 is positioned relative to the conduit 502 received in the housing portion 562 to flare the entry port 508 of the conduit 502, as indicated by arrow 572.

In some examples, after positioning the catheter 502 within the cavity 566B, and prior to advancing the pin 550 into the access port 508, the clinician can move the housing portion 562 into the closed configuration to surround and engage at least a portion of the catheter 502 including the access port 508. For example, moving the housing portion 562 to the closed configuration, the catheter 602 can be engaged by a friction fit between at least a portion of the inner surface 564 and at least a portion of the elongate body 506 to help hold the catheter 502 in place relative to the housing portion 562. As such, the inner surface 564 of the housing portion 562 is configured to engage the outer surface of the catheter 502 proximate the access port 508 such that the pin 550 can be advanced into the lumen 505 via the access port 508 to increase the cross-sectional size of the access port 508.

In some examples, the catheter flaring device 560, e.g., the pin 550, can include a button 558 or other spherical structure to facilitate advancement of the pin 550 into the lumen 505 of the catheter 502. For example, the clinician may apply an urging force to button 558 to urge pin 550 in the direction indicated by arrow 572. The button 558 may enable a clinician to apply a greater or more consistent urging force to the pin 550 to urge the pin 550 into the lumen 505 via the access port 508 without the button 558 and the spring 568. For example, the button 558 may provide a structure for a clinician to grasp and may also act as a stop to prevent the pin 550 from advancing into the lumen 505 of the catheter 502 beyond a desired point, which may result in the lip having a length that is longer than desired.

In some examples, the conduit flaring device 560 can include a recessed return 568. Recessed return 568 may be configured to return pin 550 to the original position upon release of the pushing force that pushed pin 550 into entry port 508 of catheter 502. For example, recessed return 568 may apply a force to pin 550 in the direction indicated by arrow 570. As depicted in fig. 5, the recessed return 568 comprises a coil spring. In other examples, the recessed return 568 may include one or more different mechanical or pneumatic cylinders.

Fig. 6A and 6B are photographs depicting a top view and a side view of an exemplary conduit 602 before flaring an entry port 608, and fig. 6C and 6D are photographs depicting a front view and a side view of the conduit 602 after flaring the entry port 608. The catheter 602 may be the same as or substantially similar to the

catheters

102, 202, 302, 402, and 502 discussed above with reference to fig. 1-5, except for the differences described herein. For example, catheter 602 includes a pusher assembly 610 having an anchoring member 611 coupled to elongate body 606. Elongate body 606 may extend along a longitudinal axis and define a lumen 605 that terminates in an access port 608. Access port 608 extends along the length of elongate body 606 from a proximal end (not shown) to a distal end 632.

As depicted in fig. 6A and 6B, prior to flaring the access port 608, the access port 608 does not include a lip. In examples where the conduit 602 is a guide extension conduit, the conduit 202 may define a mismatch with a guide conduit (not shown). Similar to that discussed above with reference to fig. 2A and 2B, in some cases, the mismatch may be about 0.33mm to about 2mm, such as about 0.5mm to about 1 mm. To reduce medical device jamming on the access port 608, a flaring device, such as a catheter flaring device 560, may be used to modify the access port 608, for example, to flare the access port 608 to better match the outer diameter of elongate body 606 with the inner diameter of a second catheter, such as a guide catheter.

As depicted in fig. 6C and 6D, after the access port 608 is flared, for example using a conduit flaring device 560, the access port 608 defines a lip 628. Similar to that discussed above with reference to fig. 3A and 3B, lip 628 is configured to reduce mismatch between catheter 602 and, for example, the inner diameter of a guide catheter. The lip 628 may include at least one of a selected orientation relative to the access port 608, a selected cross-sectional dimension (e.g., diameter or length), a selected length L from the access port 608 to an un-flared portion of the elongate body 606 of the conduit 602, or an arc subtending a selected angle to an outer circumference of the access port 608. By flaring the entry port 608, the outer circumference of the conduit 602 may better correspond to the inner diameter of the second conduit, for example, as compared to an un-flared conduit.

The medical device systems described herein may be used to flare an access port of a catheter, such as a guide extension catheter. FIG. 7 is a flow diagram depicting an exemplary technique for modifying an access port of a catheter. Although the technique depicted in fig. 7 is described with reference to the medical device system 500 described above with reference to fig. 5, the technique may be used with other medical device systems, such as one or more of the

medical device systems

100, 200, 300, or 400.

The technique depicted in FIG. 7 includes positioning at least the entry port 508 of the conduit 502 in the cavity 566 of the housing portion 562 of the flaring device 560. As discussed above, catheter 502 may include an elongate body 506 extending along a longitudinal axis and defining a lumen 505 that terminates in an access port 508. Also, as discussed above, the flaring device 560 can include a housing portion 562 and a pin 550. The housing portion 562 may include an inner surface 564 that defines a cavity 566 shaped to receive a portion of the conduit 602. The inner surface 564 of the housing portion 562 may be configured to engage the outer surface 503 of the conduit 502 proximate the access port 508.

The technique depicted in fig. 7 also includes advancing a pin 550 into the lumen 505 through the entry port 508 of the conduit 502 to flare the entry port 508. The flared access port 508 may define a flared lip (e.g., flared lip 428) extending away from the central longitudinal axis X of the elongate body 506. In examples where the shape of the inner surface 564 of the housing portion 562 corresponds to the selected flared shape of the entry port 508 of the conduit 502, advancing the pin 550 may include advancing the pin 550 until the flared lip contacts the inner surface 564 of the housing portion 562. As such, the inner surface 564 may include a positive stop to prevent over-flaring of the access port 508.

In instances where the flaring device 560 further includes a recessed return 568, the technique can include, after advancing the pin 550, releasing the force applied to the advancing pin 550 into the lumen 505 via the entry port 508 of the catheter 502. In some examples, recessed return 568 may automatically return pin 550 to the original position after the force is released. The home position may include the position of the pin 550 such that the pin 550 does not extend into the lumen 505 via the entry port 508. By automatically returning pin 550 to the original position, the clinician may not need to manually return pin 550 to the original position.

In examples where the flaring device 560 includes a heating element configured to soften at least the material of the conduit 502, the technique can include applying heat to at least a portion of the conduit via the heating element. Heating at least a portion of the conduit 502 may reduce the amount of force required to flare the entry port 508.

The clinician may modify the access port 508 of the catheter 502 at any suitable time, such as in a clinic (e.g., a catheter suite) before or during a medical procedure, using the techniques described with reference to fig. 7, or using other devices and techniques described herein.

The following clauses set forth the example subject matter described herein.

Clause 1. a device, comprising: a housing comprising an inner surface defining a cavity configured to receive at least a portion of a conduit having an entry port, wherein the inner surface of the housing is configured to engage an outer surface of the conduit proximate the entry port; and a pin configured to be advanced into the entry port of the catheter to increase a cross-sectional dimension of the entry port when at least the portion of the catheter is positioned in the cavity.

The apparatus of clause 2. the apparatus of clause 1, wherein the pin is configured to flare at least a portion of the entry port of the conduit.

Clause 3. the device of clause 1 or 2, wherein the distal portion of the pin defines a conical shape.

Clause 4. the device of any one of clauses 1-3, wherein the distal portion of the pin defines a conical shape that is eccentric relative to a central longitudinal axis of the proximal portion of the pin.

Clause 5. the device of any one of clauses 1-4, wherein the pin is mechanically coupled to the housing in sliding engagement.

Clause 6. the device of any one of clauses 1-5, further comprising a concave return device configured to return the pin to an original position upon release of a force urging the pin into the entry port of the catheter.

Clause 7. the device of clause 6, wherein the depression-returning means comprises a spring or pneumatic cylinder.

Clause 8. the device of any one of clauses 1-7, further comprising a heating element configured to soften the material of the conduit.

Clause 9. the device of any one of clauses 1-8, wherein the shape of the inner surface of the housing corresponds to a selected flared shape of the entry port of the conduit.

Clause 10. the device of any one of clauses 1-9, wherein the shape of the inner surface of the housing is configured to orient the entry port of the conduit in a selected direction relative to the pin.

Clause 11. the device of any one of clauses 1-10, wherein the housing comprises a first portion and a second portion mechanically coupled to the first portion by one or more hinges, wherein the first portion and the second portion are configured to move relative to each other to enclose at least the portion of the conduit.

Clause 12. a medical device system, comprising: a catheter including an elongate body extending along a central longitudinal axis and defining a lumen terminating in an access port; and a flaring device comprising: a housing comprising an inner surface defining a cavity shaped to receive at least a portion of the conduit, wherein the inner surface of the housing is configured to engage an outer surface of the conduit proximate the entry port; and a pin configured to be advanced into the entry port of the conduit to flare the entry port when at least the portion of the conduit is positioned in the cavity, thereby defining a flared lip extending away from the central longitudinal axis.

Clause 13 the medical device system of clause 12, wherein the flared lip of the access port tapers in a distal direction toward the central longitudinal axis.

Clause 14 the medical device system of clause 12 or 13, wherein the flared lip is asymmetric with respect to the central longitudinal axis.

Clause 15. the medical device system of any of clauses 12-14, wherein the angle of the flared lip relative to the central longitudinal axis is greater than 0 degrees to about 45 degrees.

Clause 16. the medical device system of any one of clauses 12-15, wherein the flared lip has a length in a direction parallel to the central longitudinal axis of about 3 millimeters to about 5 millimeters.

Clause 17 the medical device system of any one of clauses 12-16, wherein the outer perimeter of the flared lip subtends an angle from about 45 degrees to about 315 degrees.

Clause 18. the medical device system according to any one of clauses 12-17, wherein the catheter is a guide extension catheter including the elongate body and a pushing assembly, the pushing assembly including an elongate member and an anchoring member, wherein a maximum cross-sectional dimension of the elongate member is smaller than a cross-sectional dimension of the access port, wherein the anchoring member is positioned at a distal end of the elongate member and secured to the elongate body proximal to the access port.

Clause 19. the medical device system of any one of clauses 12-18, wherein the pin defines a conical shape having a central axis that is eccentric relative to the central longitudinal axis of the catheter when at least the portion of the catheter is positioned in the cavity.

Clause 20. the medical device system of any one of clauses 12-19, wherein the pin is mechanically coupled to the housing in a sliding engagement.

Clause 21. the medical device system of any one of clauses 12-20, wherein the flaring device further comprises a recess return device configured to automatically return the pin to an original position upon release of a force urging the pin into the entry port of the catheter.

Clause 22. the medical device system according to claim 21, wherein the depression-returning means comprises a spring or a pneumatic cylinder.

Clause 23. the medical device system of any one of clauses 12-22, wherein the flaring device further comprises a heating element configured to at least soften the material of the catheter.

Clause 24. the medical device system of any of clauses 12-23, wherein a shape of the inner surface of the housing corresponds to a selected flared shape of the entry port of the catheter.

Clause 25. the flaring device of any of clauses 12-24, wherein said shape of said inner surface of said housing is configured to orient said entry port of said conduit in a selected direction relative to said pin.

Clause 26. a method, comprising: positioning at least one entry port of a conduit in a cavity of a housing of a flaring device, wherein the conduit comprises an elongate body extending along a central longitudinal axis and defining a lumen terminating in the entry port, and wherein the flaring device comprises: the housing includes an inner surface defining the cavity shaped to receive at least a portion of the conduit including the access port, wherein the inner surface of the housing is configured to engage an outer surface of the conduit proximate the access port; and a pin; and when the at least one entry port of the conduit is positioned in the cavity of the housing, advancing the pin into the entry port of the conduit to flare the entry port to increase a cross-sectional dimension of the entry port.

Clause 27. the method of clause 26, wherein advancing the pin into the entry port of the conduit increases a cross-sectional dimension of the entry port at least by flaring a lip of the conduit.

Clause 28. the method of clause 26 or 27, wherein advancing the pin comprises advancing the pin until the access port contacts the inner surface of the housing.

Clause 29. the method of any of clauses 26-28, wherein the flaring device further comprises a recess return device, wherein the method further comprises releasing the applied force to advance the pin into the entry port of the catheter after advancing the pin, wherein the recess return device automatically returns the pin to an original position after releasing the force.

Clause 30. the method of any of clauses 26-29, wherein the flaring device further comprises a heating element configured to at least soften the material of the conduit, wherein the method further comprises applying heat to at least the portion of the conduit via the heating element.

Clause 31. the method of any of clauses 26-30, further comprising selecting the flaring device based on a desired flaring shape of the entry port of the conduit.

Various examples have been described. These and other examples are within the scope of the following claims.

Claims

1. An apparatus, comprising:

a housing comprising an inner surface defining a cavity configured to receive at least a portion of a conduit having an entry port, wherein the inner surface of the housing is configured to engage an outer surface of the conduit proximate the entry port; and

a pin configured to be advanced into the entry port of the catheter to increase a cross-sectional dimension of the entry port when at least the portion of the catheter is positioned in the cavity.

2. The device of claim 1, wherein the pin is configured to flare at least a portion of the entry port of the conduit.

3. The device of claim 1, wherein a distal portion of the pin defines a conical shape.

4. The device of claim 1, wherein the distal portion of the pin defines a conical shape that is eccentric relative to a central longitudinal axis of the proximal portion of the pin.

5. The device of claim 1, wherein the pin is mechanically coupled to the housing in a sliding engagement.

6. The device of claim 1, further comprising a recessed return device configured to return the pin to an original position upon release of a force urging the pin into the entry port of the catheter.

7. The device of claim 6, wherein the depression return device comprises a spring or pneumatic cylinder.

8. The device of claim 1, further comprising a heating element configured to soften material of the conduit.

9. The device of claim 1, wherein the shape of the inner surface of the housing corresponds to a selected flared shape of the entry port of the conduit.

10. The device of claim 1, wherein the shape of the inner surface of the housing is configured to orient the entry port of the conduit in a selected direction relative to the pin.

11. The device of claim 1, wherein the housing comprises a first portion and a second portion mechanically coupled to the first portion by one or more hinges, wherein the first portion and the second portion are configured to move relative to each other to enclose at least the portion of the conduit.

12. A medical device system, comprising:

a catheter including an elongate body extending along a central longitudinal axis and defining a lumen terminating in an access port; and

a flaring device, comprising:

a housing comprising an inner surface defining a cavity shaped to receive at least a portion of the conduit, wherein the inner surface of the housing is configured to engage an outer surface of the conduit proximate the entry port; and

a pin configured to be advanced into the entry port of the conduit to flare the entry port when at least the portion of the conduit is positioned in the cavity, thereby defining a flared lip extending away from the central longitudinal axis.

13. The medical device system of claim 12, wherein the flared lip of the access port tapers in a distal direction toward the central longitudinal axis.

14. The medical device system of claim 12, wherein the flared lip is asymmetric with respect to the central longitudinal axis.

15. The medical device system of claim 12, wherein the angle of the flared lip relative to the central longitudinal axis is greater than 0 degrees to about 45 degrees.

16. The medical device system of claim 12, wherein a length of the flared lip in a direction parallel to the central longitudinal axis is about 3 millimeters to about 5 millimeters.

17. The medical device system of claim 12, wherein the outer circumference of the flared lip subtends an angle from about 45 degrees to about 315 degrees.

18. The medical device system of claim 12, wherein the catheter is a guide extension catheter including the elongate body and a pushing assembly, the pushing assembly including an elongate member and an anchoring member, wherein a maximum cross-sectional dimension of the elongate member is smaller than a cross-sectional dimension of the access port, wherein the anchoring member is positioned at a distal end of the elongate member and is secured to the elongate body proximate the access port.

19. The medical device system of claim 12, wherein the pin defines a conical shape having a central axis that is eccentric relative to the central longitudinal axis of the catheter when at least the portion of the catheter is positioned in the cavity.

20. The medical device system of claim 12, wherein the pin is mechanically coupled to the housing in a sliding engagement.

21. The medical device system of claim 12, wherein the flaring device further includes a recessed return device configured to automatically return the pin to an original position upon release of a force that advances the pin into the entry port of the catheter.

22. The medical device system of claim 21, wherein the depression return device comprises a spring or pneumatic cylinder.

23. The medical device system of claim 12, wherein the flaring device further comprises a heating element configured to soften at least a material of the catheter.

24. The medical device system of claim 12, wherein a shape of the inner surface of the housing corresponds to a selected flared shape of the entry port of the catheter.

25. The medical device system of claim 12, wherein the shape of the inner surface of the housing is configured to orient the entry port of the catheter in a selected direction relative to the pin.

26. A method, comprising:

positioning at least one entry port of a conduit in a cavity of a housing of a flaring device, wherein the conduit comprises an elongate body extending along a central longitudinal axis and defining a lumen terminating in the entry port, and wherein the flaring device comprises:

the housing includes an inner surface defining the cavity shaped to receive at least a portion of the conduit including the access port, wherein the inner surface of the housing is configured to engage an outer surface of the conduit proximate the access port; and

a pin; and

when the at least one entry port of the conduit is positioned in the cavity of the housing, the pin is advanced into the entry port of the conduit to flare the entry port, thereby increasing a cross-sectional dimension of the entry port.

27. The method of claim 26, wherein advancing the pin into the entry port of the conduit increases the cross-sectional dimension of the entry port at least by flaring a lip of the conduit.

28. The method of claim 26, wherein advancing the pin includes advancing the pin until the access port contacts the inner surface of the housing.